Presentation (CTI)

OBJECTIVES: In 2020, 11,504 new cases of hepatocellular carcinoma (HCC) were reported, with incidence rates continuing to rise. On the same year, the management of advanced and metastatic HCC experienced significant progress with the introduction of combined immunotherapy-anti-angiogenic agent (atezolizumab + bevacizumab) as first line treatment further promoting the transition from outpatient to inpatient care. This study aims to analyze the evolution of hospital management and treatment pathways for patients with advanced and metastatic HCC in France between 2020 and 2021.
METHODS: A retrospective observational study was conducted using the French hospital discharge database (PMSI). All adult patients with an HCC ICD-10 code (C220) within at least one hospital stay and a systemic treatment, excluding adjuvant therapy, between 2020 and 2021 were included. Treatment pattern, patient characteristics, and patient pathway were analyzed using descriptive statistics.
RESULTS: In 2020 and 2021, a total of 3,329 patients initiated hospital-based systemic treatment for HCC, with 1,028 patients recorded in 2020 and 2,301 in 2021, representing a 123% increase over the two-year period. The average age of these patients was 68 years, 81% were male and 48% of them were treated in university hospital. 2061 patients (62%) received at least one combined administration of atezolizumab + bevacizumab but less than 68% of them (N=1404) had the combined therapy in all treatment cycle. An oesogastroduodenal endoscopy was performed for 53% of patients (N=1048) before treatment initiation.
CONCLUSIONS: This study highlighted the evolution of inpatient care for the management of advanced or metastatic HCC with the adoption of a new standard of treatment. However, limitations such as the absence of data on outpatient management and therapies, inherent to the database used, should be considered when interpreting the findings.